IngentaConnect Lansoprazole, levofloxacin and amoxicillin triple therapy vs. qua...

Authors: WONG, W. M.; GU, Q.; CHU, K.-M.¹; YEE, Y. K.²; FUNG, F. M. Y.²; TONG, T. S. M.²; CHAN, A. O. O.²; LAI, K. C.²; CHAN, C. K.²; WONG, B. C. Y.²

Source: Alimentary Pharmacology & Therapeutics, Volume 23, Number 3, February 2006 , pp. 421-427(7)

Publisher: Blackwell Publishing

Abstract:

Summary Aim

To test the efficacy of levofloxacin-based second-line therapy for resistant Helicobacter pylori infection. Methods

One hundred and six patients who failed H. pylori eradication were randomized to receive (i) lansoprazole 30 mg, amoxicillin 1 g, levofloxacin 500 mg, all given twice daily for 7 days (LAL); or (ii) lansoprazole 30 mg twice daily, metronidazole 400 mg thrice daily, bismuth subcitrate 120 mg and tetracycline 500 mg four times daily for 7 days (quadruple). Post-treatment H. pylori status was determined by ¹³C-urea breath test. Results

Intention-to-treat and per-protocol H. pylori eradication rates were 57/60% for the LAL group and 71/76% for the quadruple group respectively. Metronidazole, clarithromycin, amoxicillin and levofloxacin resistance were found in 76%, 71%, 0% and 18% of patients, respectively. Levofloxacin resistance led to treatment failure in the LAL group. For patients with dual resistance to metronidazole and clarithromycin, the eradication rates were 79% in the LAL group (levofloxacin-sensitive) and 65% in the quadruple group (P = 0.34). Conclusion

Lansoprazole, amoxicillin plus levofloxacin second-line therapy is comparable with quadruple therapy in efficacy. Subjects, especially those with dual resistance to metronidazole and clarithromycin, may consider levofloxacin-based therapy for levofloxacin-sensitive strains.

Document Type: Research article

DOI: 10.1111/j.1365-2036.2006.02764.x

Affiliations: 1: Surgery, Queen Mary Hospital, The University of Hong Kong, Hong Kong 2: Medicine

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Lansoprazole, levofloxacin and amoxicillin triple therapy vs. quadruple therapy as second-line treatment of resistant Helicobacter pylori infection